John Chin Wah, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C6133 Issued in AR

Practice address

230 West Broadway
West Memphis, AR 72301

Phone

(870) 735-8246

Fax

(870) 735-0481

NPI assigned

Feb 27, 2006

Last updated

Oct 13, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1467428847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 WEST BROADWAY",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "72301",
            "telephone_number": "870-735-8246",
            "fax_number": "870-735-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 WEST BROADWAY",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "72301",
            "telephone_number": "870-735-8246",
            "fax_number": "870-735-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAH",
        "first_name": "JOHN",
        "middle_name": "CHIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C6133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114933001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.